Nighttime angina: what to know

Angina is discomfort caused by reduced blood flow to the heart muscle. It may feel like pressure, squeezing, heaviness, burning, or tightness in the chest, and can spread to the arm, shoulder, neck, jaw, or back. Night symptoms may occur at rest, during vivid dreams, after a late meal, or with changes in the heart's workload. Hypertension and other cardiovascular conditions can increase concern, but chest tightness has several possible causes and cannot be diagnosed from symptoms alone. An ECG records the heart's electrical activity and may be part of an assessment.

If a clinician has given you an angina plan, stop activity, sit or rest, and use prescribed medicine exactly as directed. Do not borrow someone else's medicine or drive yourself if symptoms are concerning. Arrange prompt medical review for symptoms that are new, changing, occurring at rest, or waking you from sleep. A clinician may review blood pressure, medicines, risk factors, and whether tests or treatments such as blood pressure medication or statin therapy are appropriate.

Call emergency services immediately for chest pressure or tightness that is severe, lasts several minutes, returns, or occurs with breathlessness, cold sweating, nausea, faintness, or pain spreading to the arm, jaw, or back. Treat sudden nighttime chest symptoms as urgent even if you are unsure whether they are angina. Do not wait for a routine appointment when symptoms are worsening or unfamiliar.

Ask how to recognise your personal angina pattern, what to do if symptoms occur at rest, and when to call emergency services. Discuss whether an ECG, blood-pressure review, or changes to blood pressure medication or statin therapy are appropriate for you.